Organization
DR TRACEY J SHAFFER, OPTOMETRIST PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACEY J SHAFFER OD (OWNER)
(757) 456-5550
Entity
Organization
Contact information
Practice address
4588 VIRGINIA BEACH BLVD, CARE OF SEARS OPTICAL, VIRGINIA BEACH, VA 23462-3004
(757) 456-5550
(757) 456-0091
Mailing address
705 ERIK PAUL DR, CHESAPEAKE, VA 23322-3717
(757) 456-5550
(757) 456-0091
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000633
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457371502
—
VA
Enumeration date
02/13/2008
Last updated
09/08/2010
Update your record
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